Korean J Med.  2012 Oct;83(4):534-537.

A Case of Biliary Sepsis Caused by Hafnia Alvei in a Patient with Cholangiocarcinoma

Affiliations
  • 1Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. imjy96@yuhs.ac

Abstract

Hafnia alvei is a Gram-negative rod that is rarely isolated from human specimens and is rarely pathogenic. It has been associated with gastroenteritis, pneumonia, urinary tract infection, bacteremia, and nosocomial wound infection, but extra-intestinal H. alvei infection is very rare. We present a case of biliary sepsis caused by H. alvei. A 42-year-old woman was admitted with abdominal pain and jaundice. She was diagnosed with metastatic cholangiocarcinoma and received conservative treatment. Six days later, hyperbilirubinemia and signs of sepsis developed and H. alvei was isolated from both the bile and blood. Despite treatment with antibiotics the organism was sensitive to (it was documented as susceptible to piperacillin/tazobactam and ciprofloxacin in sensitivity tests), the patient's condition grew worse. The antibiotics were switched to meropenem and the biliary sepsis was resolved.

Keyword

Hafnia alvei; Infection, Biliary Tract; Bacteremia

MeSH Terms

Abdominal Pain
Adult
Anti-Bacterial Agents
Bacteremia
Bile
Cholangiocarcinoma
Ciprofloxacin
Female
Gastroenteritis
Hafnia
Hafnia alvei
Humans
Hyperbilirubinemia
Jaundice
Pneumonia
Sepsis
Thienamycins
Urinary Tract Infections
Wound Infection
Anti-Bacterial Agents
Ciprofloxacin
Thienamycins
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